Brief Answer:
Neurological Examination May be of Benefit

Detailed Answer:
Good evening. I have read your previous consults on this network from other colleagues. Taking those consults into considerations my impression is that the major symptom you are having of what you mention up top is lower back pain and spasms. Is that correct? Other symptoms of numbness and tingling in the upper extremities as well as difficulty finding words, shakes, and confusion do not seem to be as distressing to you when I see how you've mentioned those items as well in the other queries.

Therefore, a neurological examination would be very helpful to get with someone who can actually do a hands on assessment for you since your description unfortunately brings together some things that seem to be a bit unrelated. For example, the numbness and tingling in the upper extremities with low back tightness and feelings of spasms are likely unrelated as would be the dizziness, confusion, and difficulty finding words or saying words correctly as related to the back symptoms.

And so, a good solid neurological examination looking a motor, sensory, and reflex symptoms would be very helpful. Also, an assessment of your ability to read, comprehend, and steadiness on your feet when lying down vs. standing up would be helpful information to have based upon your symptoms.

Apparently, you've had a back injury this past September but you also mentioned that you'd suffered an injury to the back about 10 years ago as well and that there was a herniated disc, correct?

If I were your neurologist I would take a very thorough and detailed history of when you first starting to have symptoms of the back pain/spasms as well as the tingling in the upper extremities and get imaging studies as necessary of the back (either CT scan or MRI). You had mentioned having been diagnosed with a herniated disk syndrome of some sort. Is that definitely true? If so, can you either upload the radiographic report or the film that shows the herniation.

I would definitely wish to order certain lab tests on you such as your thyroid function, your liver, and kidney functions, and your electrolytes such as sodium, potassium, and chloride. There would be other tests for sure but those to start. I would also CONSIDER an electrical study if nothing else showed up on either the interview or physical examination. Some of your symptoms are also in all probability anxiety driven and this is something that would have to be tackled by someone who is an expert such as a psychologist or psychiatrist.

I believe you should also participate in a PHYSICAL EXERCISE program in ADDITION to simple stretching maneuvers as this will hopefully loosen up a few problem areas in your body which are being caught as spasms that I believe you have (part of health related anxiety issues).

I hope this addresses your initial concerns and that you'll keep me in mind for future questions regarding these or other neurological/medical issues. Feel free to upload images if you'd like

Otherwise, I'd appreciate your rating this interaction with a HIGH STAR SCORE and look forward to a few words of feedback. In addition, I'd appreciate your CLOSING THIS QUERY if you're satisfied with my response.

Write to me any time at: bit.ly/drdariushsaghafi for additional comments, concerns, or to provide status updates if you'd like which I would love to receive from you to see just what has been discovered.

Many thanks for using this service to ask your questions. Be well.

This consult request has taken a total of 18 minutes of time to read, research, and respond.

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